Our study indicates that in pediatric CT, ATCM, organ radiation doses, and image noise were substantially affected by vertical patient positioning, with radiation dose differences compared to the 0-position of up to 34%. Our results extend the current body of literature for pediatric CT of the head and trunk by the following main findings: i) the impact of patient positioning depends on the body region and location of each individual organ within the body; ii). differences in organ dose are caused by both ATCM and bowtie filter in thoracoabdominal CT, but are mainly affected by the bowtie filter in head CT; iii) scatter radiation is not significantly related to patient position; and iv) lateral scout images can negatively impact ATCM.

Radiation dose differences of up to 34% compared to the isocenter highlight the necessity to train technologists to position pediatric patients accurately.